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� <br /> Sec.13.04 RIGHTS OF SUBJECTS OF DATA <br /> Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. <br /> Subd.2. Information required to be given individual. An individual asked to supply private or confideatial data concerning himself shall be <br /> informed of: (a)the purpose and intended use o[the requested data within the collecting state agency,political subdivision,or statew-ide system;(b) <br /> whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising fmm his supplying or refusing to supply <br /> private or confidential data;and(d)the identity oCother persons or entities authorized by state or federal law to receive the data. This requirement shall <br /> not apply when an individual is asked to supply investigative data,pursuant to sectioo 13.82,subdivision 5,to a law enforcement officer. <br /> The commissioner of revenue mav lace the notice re uired under this subdivision in the individual income tax or ro ertv tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individual. lipon request to a responsible authority,ao individual shall be informed whether he is the subject of <br /> stored data on individuals,and whether it is classified as public,private or rnnfidential. Upon his(urther request,an individuai who is the subject of <br /> stored private or pubiic data on individuais shall be shown the data without any cha se to him and,(f he desires,shall be inlormed of the content and <br /> meaning of that data. After an individual has been shown the private data and informed o[its meaning,the data need not be disclosed to him for six <br /> months therea(ter unless a dispute or action pursuant to this section is pending or additional data on the individual has been coliected or created. The <br /> responsibie authority shall provide copies of the private or public data upon request b}-the individual subject of the data. The responsible authority may <br /> require the requesting person to pay the actual costs of making,certifying,and compiling the copies. <br /> The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or N ithin fi�•e days o[the <br /> date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comph w ith the requestwithin <br /> that time,he shail so inform the individual,and may have an additionai five days within which to comply with the request,excludin;Saturdays,Sundays <br /> and legal holidays. <br /> Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness o(public or private data <br /> concerning himselL To exercise this right,an indi�idual shall notify in writing the responsible authority describing the nature of the disagreement. The <br /> responsible authority shall within 30 da}�s either: (a)correct the data found to be inaccurate or incomplete aud attempt to notify p�st recipients of <br /> tnaccurate or incomplete data,including recipients named by the individual;or(b)oodf�•the individual that he believes the data to be correct, Data in <br /> dispute shail be disclosed only if the individual's statement of disagreement is included with the disclosed data. <br /> The determination o[the responsible authority may be appealed pursuant to the provisions o(the administrative procedure act relating to <br /> contested cases. <br /> D�TA PRIVACY AD�ZSORY <br /> In accordance�vith NI.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that}-our request <br /> for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or <br /> confidential information. <br /> You are notified that: <br /> 1. The information you furnish will be used to determine}-our qualification for the permit or license requested. <br /> 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. <br /> 3. The information may be shared with other local,state or federal agencies to the estent necessar�-to process <br /> the permit or license. <br /> 4. If your requested permit or license requires Council action to approve, some information may become <br /> public. <br /> 5. You have certain rights under NI.S. 13.04(a�•ailable upon request)to review private data on�-ourself. <br /> 6. Your fult name is required to process this application or permit. <br /> First �Iiddle � <br /> // Last <br /> /�o��l) `l 7.(1r 1 7�� <br /> Address <br /> G �/� fl�Yf P� ✓01/1'l � s� .S� ( S o� 7�S �<,7(,� j <br /> ty State <br /> Z�P Phone <br /> I understand my rights as stated above. <br /> " ,� � <br /> Signature <br />